PD017 - ACCURATE DIAGNOSIS YET A SIGNIFICANT TREATMENT GAP IN CHILDHOOD MALNUTRITION: A NATIONWIDE STUDY

PD017

ACCURATE DIAGNOSIS YET A SIGNIFICANT TREATMENT GAP IN CHILDHOOD MALNUTRITION: A NATIONWIDE STUDY

A. Alptekin Sarioglu^1,* on behalf of on behalf of the MUAC Study Group

¹Abbott Nutrition, Abbott Laboratories, Istanbul, Türkiye

Rationale: Mid-upper arm circumference (MUAC) z score is a simple way to assess childhood nutritional status and define severity. Evaluating its real-world diagnostic use clarifies the recognition of malnutrition and initiation of nutritional treatment.

Methods: A total of 15,732 pediatric outpatients (median(min–max) age: 96 (2–228) months 50.7% girls) were included in this cross-sectional real-world study conducted at 83 pediatric centers (general pediatrics: 42.6%, pediatric gastroenterology: 39.0%, pediatric neurology: 16.1%, pediatric hematology–oncology: 1.2% and pediatric surgery: 1.0%) across Türkiye. According to national reimbursement criteria, malnutrition was defined as z score ≤ −2 using weight for age (WFA) in children aged 2–60 months and body mass index (BMI) in those aged 61–228 months. MUAC z scores were assessed in children aged ≥2 months using a standardized MUAC z score tape.

Results: Physicians identified malnutrition by clinical observation “at first sight” in 3,072 children (19.5%). However, when reimbursement based anthropometric criteria were applied, treatment-eligible moderate-to-severe malnutrition was identified in 12.5% overall (2-60 months: MUAC:10.7%, WFA:12.2%; 61-120 months: MUAC:14.5%, BMI:12.4%; 121-228 months: MUAC:20.7%, BMI:12.8%). Despite eligibility, only 53% of children received nutritional treatment. MUAC z scores showed strong correlations with WHO reference standards, particularly WFA (r=0.668) and BMI (r=0.681; p<0.001) (Fig 1).

Image:

Conclusion: MUAC z score assessment is a reliable and practical screening tool that supports early identification and follow‑up. Given the significant treatment gap despite the documented eligible malnutrition, reframing z score −2 SD as a non-negotiable action threshold rather than a waiting point may help close the gap between detection and effective nutritional intervention in Türkiye. 

Disclosure of Interest: A. Alptekin Sarioglu Other: Aysugul Alptekin Sarioglu, M.D. is an Abbott employee. Other authors declare that they have no conflict of interest